Make A Gift Online
If you wish to designate your gift to a specific fund or area or to divide among University programs, please indicate your instructions in the "comments" section at the bottom of the form.

PRIVACY INFORMATION: The Information provided on this form will only be used by the University of Rochester Gift Office to process your gift and by the University of Rochester for its related activities. The information will not be sold to a third party.

Please complete the following information. Required fields are marked with an asterisk (*).

Personal Information

Title: (Mr.,Ms., etc.)

First Name: *

Middle Name:

Maiden Name:

Last Name: *

Suffix: (Jr.,Sr., etc.)

Email Address *

Class Year:

Please enter your phone number in the following format: xxx-xxx-xxxx.

Daytime Phone Number:

Evening Phone Number:

Billing Address

Street Address1: *

Street Address2:

Street Address3:

City: *

State:

Postal Code: *

Country: *

Gift Information

Gift Amount: *$

Please designate my gift: *

Other gift designation:

If you wish to designate your gift to more than one area of the University, or if you have special instructions, please provide them below. We will distribute your gift amount equally among all the areas you indicate unless you specify otherwise. A five-year pledge of $1,500 or more per year may qualify you for George Eastman Circle membership. Click here here for more information.

Comments

You have reached the character limit for this input field (1000 characters).

Appeal Code:

Check here if this is a joint gift.

If you checked the box above, please enter information about your spouse or partner:

Spouse/Partner First Name:

Spouse/Partner Last Name:

If your spouse or partner is a graduate of the University of Rochester, please enter the class year:

Spouse/Partner Class Year:

Check if your company has a matching gift program.

If you checked the box above, please enter the name of the company.

Company Name:

Use our convenient look up to see if your company has a matching gift program, access forms online, and more.

If applicable, please complete and mail the Matching Gift Form (available from the human resources department of the company that has the matching gift program) to the following address: